Recognising the Signs of Elder Abuse

Elder abuse is a health and safety issue, not a taboo topic. Everyone has the right to feel safe at home and in their relationships, at every age. This is one of the harder things to think about as a family member, but it's genuinely common enough, and often subtle enough, that it's worth knowing what to actually look for.

Who this applies to

In England, the Care Act 2014 describes an “adult at risk” as someone aged 18 or over who has care and support needs, and who is experiencing, or at risk of, abuse or neglect, and is unable to protect themselves from it because of those needs. Scotland has its own equivalent under the Adult Support and Protection (Scotland) Act 2007, and Wales under the Social Services and Well-being (Wales) Act 2014, with broadly similar principles.

The recognised categories

The Care Act 2014 sets out ten categories of abuse. They're not exhaustive, and situations often overlap, but they're a useful checklist for what to be alert to:

• Physical — hitting, pushing, misuse of medication, or inappropriate restraint.
• Emotional or psychological — humiliation, intimidation, or being ignored and isolated.
• Financial or material — theft, fraud, pressure over a will, or misuse of someone's money or property.
• Neglect and acts of omission — withholding food, medication, warmth, or access to care.
• Domestic abuse, including coercive control — a pattern of controlling behaviour by a partner, family member or carer.
• Sexual abuse — any sexual activity without full, informed consent.
• Self-neglect — including severe hoarding, or an inability to manage personal care or living conditions.
• Discriminatory abuse — treatment based on race, disability, sexuality or similar.
• Organisational abuse — poor care or ill-treatment within a hospital, care home or other institution.
• Modern slavery — forced labour, servitude, or trafficking.

Signs that are easy to miss

Physical injuries tend to get noticed. The quieter signs often don't, things like: unexplained changes in mood or confidence, a person seeming frightened or unusually quiet around a specific person, sudden reluctance to be left alone with someone, unexplained withdrawals from a bank account or changes to a will, bills going unpaid despite there being enough money, or a home that's noticeably less cared for than it used to be.

Trust the discomfort. If something feels off during a visit, that instinct is worth taking seriously, even if you can't immediately point to why. You don't need proof before raising a concern, that's what safeguarding teams are there to help assess.

What to actually do

If someone is in immediate danger, call 999.

For anything else, contact the adult social care safeguarding team at the local council where the person lives. Every council has a legal duty under the Care Act 2014 to make enquiries when abuse or neglect is reasonably suspected, this is a standard, expected process, not an extreme step.

For free, confidential advice at any time, day or night, Hourglass (formerly Action on Elder Abuse), the UK's only charity dedicated to this issue, runs a 24/7 helpline: 0808 808 8141. It won't show up on a phone bill, and you don't need to have decided anything yet before calling.

This is general guidance, not legal advice. If you're ever unsure whether something meets the threshold for a safeguarding concern, that uncertainty is exactly what Hourglass or your local council's safeguarding team can help you think through.

If you’ve raised a concern and feel like it’s going nowhere: Read our guide on escalating a care home complaint →

You don’t have to navigate it alone.